The Development of the Digital Cognitive Screen, Parkinson's Cognition (Par-Cog)

Recently, research has focused on understanding the assessment and management of Parkinson's Disease Mild Cognitive Impairment (PD-MCI) (Svenningsson et al., 2012). The primary aim of this two-phase study was to develop a novel cognitive assessment tool, Par-Cog (Parkinson's Cognition) designed to evaluate PD-MCI.

In Phase 1, 20 experts(including Neurologists, Geriatricians, Neuropsychologists, and PD Nurses) were recruited via social media and anonymously completed a survey on Qualtrics, providing feedback on the acceptability and validity of the Par-Cog. The qualitative data were analyzed using the content analysis method proposed by Elo & Kyngäs, 2008, while descriptive statistics analyzed the quantitative data. Phase 2 included 100 cognitively healthy participants from the British Isles, aged between 50 and 79 years, who were randomly assigned to either Group A or Group B (alternating, consecutive order for completing the Par-Cog and Addenbrookes, ACE-III) using Zoom.

In Phase 1, the Par-Cog demonstrated strong face and content validity, with high acceptability reported by experts, particularly Neuropsychologists. In Phase 2, the total and 5 domain Par-Cog scores were normally distributed, showing no floor effects. Significant ceiling effects were found for language and visuospatial scores. Mean-based percentiles were calculated, with Pearson's correlation and regression analyses revealing significant relationships between age and education with Par-Cog scores (p <.05) except for visuospatial scores. Significant correlations were found between ACE-III and Par-Cog attention, memory, and executive functioning scores (convergent validity, p < .05). Bland Altman plots indicated good agreement between Par-Cog and ACE-III scores, and the internal consistency for Par-Cog total (α = 0.70), memory (α = .60) and executive functioning (α = 0.82) scores were deemed acceptable. The administration of the test did not statistically influence Par-Cog scores (M =.51, 95% CI [-5.78, 4.74], t(98)= -1.95, p= .835).

Although the Par-Cog is still in the early stages of development, this study indicates that it serves as an effective remote assessment tool for evaluating PD-MCI, with constructs of acceptability, validity and reliability examined.